Oral Hygiene Practices for children
Begin cleaning an infant’s gums with a soft infant toothbrush and water after feedings even before the teeth erupt.
• Begin cleaning an infant’s teeth as soon as the first tooth erupts, usually around age 6 to 10 months. Use a soft infant toothbrush that is easy for the parent to hold and small enough to fit in the infant’s mouth. Lift the lips to brush the front and back of the teeth and at the gum line.
• Brush an infant’s or child’s teeth two to three times a day, preferably after eating. Brushing before bed is most important. Remember not to give the infant or child anything to eat or drink (except water) after brushing at night.
• To brush an infant’s teeth, the infant should be seated in the parent’s lap, with both facing in the same direction. To brush a child’s teeth, the parent should stand or sit behind the child, with both facing a mirror.
• For infants and children under age 2, brush the teeth with plain water. For infants and children at increased risk for tooth decay, consult with a dentist or physician about brushing their teeth with fluoridated toothpaste. (See Module 2, sections 2.1 and 2.2.)
• For children ages 2 and above, brush the child’s teeth with no more than a pea-sized amount (small smear) of fluoridated toothpaste. Make sure the child spits out the toothpaste after brushing, but do not have the child rinse with water. The small amount of fluoridated toothpaste that remains in the mouth helps build strong healthy teeth.
• Young children will want to hold the toothbrush and participate in toothbrushing, but they cannot clean their teeth well without parental help. After children have fine motor skills (for example, the ability to tie their shoelaces), typically by age 7 or 8, they can clean their teeth well on their own but should be supervised.
Feeding and Eating Practices
• Do not put the infant or child to sleep with a bottle or sippy cup or allow frequent and prolonged bottle feedings or use of a sippy cup containing beverages high in sugar (for example, fruit drinks, soda, or fruit juice), milk, or formula during the day or at night.
• Do not use a bottle to calm an infant or to put an infant to bed. Instead of a bottle try:
o Giving the infant a favorite blanket or toy
o Offering the infant a clean pacifier
o Holding, patting, or rocking the infant
o Reading to the infant
o Softly talking or singing to the infant
• If an infant is accustomed to being put to bed with a bottle, offer a bottle filled with plain water. If the infant does not adapt initially to the plain water, it may be necessary to fill the bottle with a mixture of juice and water, reducing the amount of juice slightly each night until only water is used.
• Hold the infant or child while feeding. Never prop a bottle (that is, use pillows or any other objects to hold a bottle in the infant’s mouth).
• Never add cereal to a bottle. This causes sugary fluids to pool around the teeth and can also cause choking if the infant is unable to swallow the extra food. Instead, always feed infants and children solid foods with a spoon or fork, or, if the infant or child is coordinated enough, encourage self-feeding.
• Introduce a small cup when the infant can sit up without support.
• As the infant begins to eat more solid foods and drink from a cup, the infant can be weaned from the bottle. Begin to wean the infant gradually, at about 9 to 10 months. By 12 to 14 months, most infants can drink from a cup.
• Do not dip pacifiers in sweetened foods like sugar or honey.
• Serve age-appropriate healthy snacks such as fruit, vegetables, grain products (especially whole grain), and dairy products instead of foods high in sugar such as candy, cookies, or cake.
• Offer snacks at regular times between meals only. If a child snacks frequently, brush the child’s teeth three times a day.
• Make sure the child drinks plenty of water throughout the day, especially between meals and snacks.
• Don’t offer food in return for good behavior. This teaches children that foods are rewards and can lead to the development of unhealthy habits.